retrocecal appendicitis

  Just out of curiousity, I work for a medical malpractice law firm (defense) and came across the topic of retrocecal appendicitis.  I know this means that the appendix lies behind where it's supposed to be and is harder to diagnose because of that.  What would be the symptoms of retrocecal appendicitis?  How is it definitevely diagnosed?  Would fever, nausea, vomiting and RLQ pain always be indications of appendicitis?  Would would case RLQ with out fever, nausea and vomitting?  What is chronic appendicits and how long does it last?  Can your appendix act up for many months before surgery would be involved?  I ask this because I do get RLQ without fever and the other symptoms, and GYN said it wasn't gynecoligcally related.  MD had sent me for abdominal x-rays which were negative.  This was quite some time ago and I still experience this.  Could it be due to back problem and poor posture?
_______________
Dear Diane,
Appendicitis can be a difficult diagnosis to make.  Inflammation of a retrocecal appendix can be an even greater diagnostic problem, because the pain can be in unusual locations and radiate to different sites.  The test with the best diagnostic value is a CAT scan of the abdomen.  This test may detect appendicitis as well as pelvic pathology.  Surgical removal of  the appendix and microscopic examination for inflammation (white cells, fibrosis) will conclusively prove appendicitis.
Among my surgical colleagues, there is a diversity of opinion regarding the entity of chronic appendicitis (weeks to months of pain). There are some surgeons who will remove the appendix for chronic right lower quadrant pain and fever.  These doctors believe that the chronic appendicitis occurs in people under the age of 35, although there is no objective basis for this statement. Other surgeons, however, do not accept the concept of chronic appendicitis.
Regarding your symptoms of RLQ pain there are a number of diagnostic possibilities. Crohn's disease, irritable bowel syndrome, tumors of the colon, and musculoskeletal problems can all cause RLQ pain.
This response is offered for your general information and should not replace the conclusions drawn from a careful and complete evaluation by your physician.
If you want, we would be happy to see you in the Division of Gastroenterology at Henry Ford Hospital, in order to review your records and investigate your symptoms.  You can arrange an appointment with Dr. Fogel, one of our experts in the treatment of abdominal pain.  He can be reached by calling the Henry Ford Physician Referral Line at [phone].
HFHSM.D.-rf
*keywords: appendicitis
0.4

[kim9127]

A related discussion, Pain in lower abdomen was started.

[kjennings1977]

A related discussion, Chronic RLQ Pain was started.

[casemanager68]

A related discussion, Retrocepal Appendix was started.